SEXUAL HEALTH: The worst problem a man can face

It was 9am when Jane walked into the consultation room at the sexology clinic. Elegantly dressed with long braids that hung freely below her shoulders, she wore a striped black suit, a white shirt and high-heeled shoes that brought out a sense of power and authority in her appearance. I stood up as she marched majestically towards me, her expensive perfume filling the air. She extended her hand and I obliged for what turned out to be a strong bold handshake.

“So doctor I am here to seek your professional advice before I proceed with an important decision,” she said as she settled in her seat. “I am tired of quickies and I have decided to divorce my husband.”

She was 39 years old, a marketing executive at an international pharma company. She had been married for five years and had two children. Her husband was a doctor and head of a district hospital.

“So what do you mean you are tired of quickies?” I asked.
“My husband does the chicken business in bed – you know the way a cock runs after chicken and before you realise it the game is over?”
Jane was talking about premature ejaculation. When a man ejaculates before, during or within three minutes of penetration during sex, it is termed premature ejaculation. Jane called it chicken business.
The problem with premature ejaculation is that it distresses a man’s partner, and not just him. These women are known to be totally dissatisfied with sex. A number end up divorcing – in fact, a quarter of all divorces in many countries are attributed to premature ejaculation.
“So you understand my predicament, boss,” Jane nodded vigorously.
Most affected men suffer low self-esteem. Their self-confidence is diminished. Anxiety hits them in intimate situations. While a normal man would be excited to face a lady he loves in a private place, a man with premature ejaculation feels scared and threatened. Most develop a phobia for intimacy. Many men in this situation contemplate suicide.
“But what causes this PE thing, doctor? Is there a way of treating it or should I just leave this marriage?” Jane asked.
There are two types of premature ejaculation or PE. Primary PE is when one has premature ejaculation right from the time they start having sex.

It does not resolve for the rest of their lives. Acquired PE is when a person who has previously had normal sex suddenly starts ejaculating prematurely.

Primary PE is sometimes due to genetic problems. Occasionally, the cause may be a rushed first sexual experience, which is quite common in young people. If this happens frequently it can turn into a lifelong trend.

Acquired PE is usually a complication of erectile dysfunction (ED). Men with ED tend to rush sex in the hope that they reach ejaculation before the erection turns flabby. The result is a complex situation of ED and PE.

Other causes of acquired PE include hormonal problems, especially low prolactin levels and high thyroid hormone levels. Diseases of the prostate can also lead to PE. Enlarged prostate or cancer of the prostate or even the treatment of these diseases are known to cause PE.

Depending on the type and cause of PE, treatment can be prescribed, some with good outcomes and others with unpredictable results. Suffice it to say there are medical ways of managing PE and its consequences.

“I must say that I am now confused. Should I divorce this man or what is your advice?” Jane asked. She was obviously bored with the load of information I had given her and did not know how to make use of it.

It is important to arrive at the root cause of the problem to get proper care. I therefore advised Jane to bring her husband to the clinic for assessment. Jane remained quiet for a minute, in deep thought. She then stood up and extended her hand for a final handshake.

“Let me go and synthesise this information and get back to you,” she said. It has been two years since our meeting and Jane has not come back. Maybe she went ahead with the divorce. It appears that PE could possibly be the worst sexual problem a man can face.